This week Sherine Hamdy, Assistant Professor of Anthropology at Brown University, takes “Top of the heap” readers into the field of “graphic medicine.”

Sherine Hamdy

I’ve only recently come to learn about the growing field of “graphic medicine” – graphic novels and comics that explore medicine from a personal perspective. There are a few annual conferences, and a website devoted to it here.

Clinicians have found them eye-opening for the unflinching explorations of disease and treatment from the perspectives of patients and their family members; readers gain insight into medical processes and experiences that others have lived to tell. The use of image provides another way to bring the (perhaps textually oversaturated) reader in, offering ways to visualize strange processes (like seizures, pain, auditory hallucinations, or the darkness of depression).

This has led me to ask: Might there be a space for a ‘graphic medical anthropology’ that could bring medical anthropological and bioethical insights into more public engagement? If people are visualizing pain, could we also use images to visualize analytical concepts, like “biosocialities” or “structural violence”?

I’ve been interested in how such books could serve as resources and even models for medical anthropologists, both in our teaching and in our own publications.

Initially published as an online series, Fies offers a visual-memoir about his own family’s (white, American middle-class) experience with his mom’s terminal cancer and treatment regimen. Fies uses appealing line-sketches, and also draws on comics’ use of color, charts, and graphs to narrate a family’s harrowing journey through confused medical diagnosis, radiation, surgery options, chemotherapy and the management of side effects. One would think there would be no room here for humor, but there is. One of my favorite scenes depicts how each of the three adult siblings bears the stress of their mother’s suffering and intensive treatment schedule. Fies’ wife tells him that under stress, each person becomes more of herself; and Fies depicts each of the siblings’ taking on exaggerated super-human characteristics, drawing on the superhero imagery of the genre that he is simultaneously re-fashioning into a more realistic, personal, and intimate form. The story raises important ethical questions about the meaning, for example, of individual consent when more people than the decision-maker will be significantly impacted by the decision, and when the decision-maker cannot fully understand the repercussions. I could imagine pairing this work, in class, with Sharon Kaufman’s ethnography …And A Time To Die to think about how end of life care is managed medically in the U.S., or with Julie Livingston’s Improvising Medicineto raise questions about medical intervention and aggressive cancers in radically different settings. How can it be that the radically different use of resources in an “impressive” U.S. research hospital vs. in Botswana’s only cancer ward can yield similarly grim outcomes?

This book is a much longer memoir, and grapples with two medical themes: depression and infertility, with an emphasis on the latter. The author-illustrator, a college-educated white American woman, chronicles her quest to conceive a child and the financial, bodily, emotional, and social stresses that the battery of infertility tests poses on her and her husband. Her pursuit to become a mother is part of a larger story of coming to terms with who she is as a person as she navigates her revolutionary political views, her mother’s emotional unavailability, her increasing preoccupation with her Jewish identity, and her yet-to-be fulfilled desire to be an artist. The sections dealing with high-intervention and high-cost fertility treatments raise a number of ethical questions about the production of desires and hopes that are ramified in consumer-oriented medicine and its uneven effects on people. I thought this might be paired in a class with Gay Becker’s The Elusive Embryo, or Elizabeth Roberts’ God’s Laboratory.

This one blew me away. It is more images than dialogue, and feels more cinematic than drawn. The medical themes it touches on include: psychiatry, radiation, and cancer. It is written from the perspective of a young (white, middle-class American) child; from six to fifteen years old. I’m afraid to say more because I don’t want to give anything away. It is a gripping, disturbing, and ultimately triumphant story.

A slim comic about a young (white, middle-class American) woman’s struggle with an eating disorder; she illustrates the voice telling her not to eat as a scribbled-skeletal image named “Tyranny” and her struggle to overcome Tyranny’s hold over her.

Originally in French, in this English translation by Anjali Singh, Peeters tells his story of living in Geneva as a comic artist and falling in love with a woman, and mother of a young boy, both of whom have HIV. It raises questions about trust, blame, intimacy, and pathologization among a sero-“discordant” (white, middle-class European) couple. It gives an honest picture of how living with HIV can be an uphill battle, even for those with ready access to anti-retroviral therapy and good medical care. At the same time, it reveals that the fragility of life lived in the shadows of HIV can give it new purpose, meaning, and appreciation for moments shared.

Originally in French, this English translation by Kim Thompson compiles six volumes of David B.’s work which details the difficulties that his brother’s severe epilepsy poses on the entire (white, middle-class, French) family.

All of these take the form of memoirs, written from the perspective of either the person with an illness or a family member. They all include the perspectives of highly-educated, middle class white Europeans or Americans.

There is so much room for this field to grow! How might the patterns and insights that social scientific and humanistic understandings of medicine be incorporated visually? What would it look like to depict a wider swath of experiences and voices?

These two, final ones, give us some inclination of what a more social-science oriented visual work might look like:

A comic satire about our present ecological troubles and the ridiculous consumer-oriented simplistic “solutions” posed as “environmental consciousness.” There is a lot of information packed in here, and the lens moves skillfully from micro to macro-processes of consumption and ecological implications. The use of line drawings is not, however, as visually powerful as the others; it feels more concerned with pedagogy than with aesthetics, and there are no personal characters to relate to as in the more personal-memoir examples.

This book is of an entirely new genre, unlike any other I have seen before. It tells the story of Marie and Pierre Curie, about the struggles of a female scientist in the Sorbonne and the strange and powerful effects of radiation – as a weapon, as a treatment, as a space tool. The book does not follow a story line, but mixes media, images, and texts and incorporates information from the Curie archives and the author’s interviews with the Curies’ granddaughter, Hiroshima survivors, radiation and space scientists, and oncological specialists. The artist, Lauren Redniss, relies on a process called cyanotype, mixing photography, paintings, drawings, and amazing color – including the use of a compound used in medicine to treat radiation sickness that produces an eerie and potent indigo-blue. Also, the cover glows in the dark! You can see some pages here.

Fantastic list. I’ve used David B.’s Epileptic in seminars several times now – great way to open a discussion about the social course of illness. I would also suggest Charles Burns’ Black Hole (Pantheon, 2005) – a bit more ethereal and dark than those listed above, but right in line. Of course I have to also mention Osamu Tezuka (The Book of Human Insects, Dororo, Ode to Kirihito, the Black Jack series…).

Great titles. I loved reading Epileptic for a medical narratives seminar. Would also recommened looking at Dana Walrath’s textual evocation of her mother’s experiences with Alzheimer’s.http://danawalrath.wordpress.com/